Wandering airway foreign body in early infancy

Accidental impaction of objects in the respiratory passage is a life-threatening condition. A 9-month-old male infant was admitted with fever, cough and respiratory distress without history of choking. He was treated as wheezy bronchitis with appropriate therapy but, did not show response. HRCT showed an impacted foreign body in the trachea which caused a partial luminal compromise. Two attempts to remove foreign body by rigid bronchoscope failed, and tracheostomy was performed due to fall in oxygen saturation. After stabilization, again saturation was falling and air entry was absent on right hemithorax. Considering the possibility of movement of foreign body in right bronchus, bronchoscope was reintroduced and foreign body was removed in piecemeal. This process was complicated with cardiorespiratory arrest, twice from which the patient was revived. Postoperative period was uneventful. So, high index of suspicion is required to diagnose such a foreign body of the tracheobronchial tree to prevent morbidity and mortality.

Pulmonary hydatid cyst in children

Hydatidosis is a zoonotic parasitic disease with global existence caused by tapeworm of family Taeniidae and genus Echinococcus. It is transmitted by feco oral route or direct contact with dogs. A 7-year-old female was admitted with cough, fever, chest pain and history of contact with dog. Chest radiography showed round to oval mass with air fluid level while ultrasonography of thorax was suggestive of a large cystic lesion in right mid zone with dense moving echo and multiple hyper echoic foci with connected artifacts without calcification. Computerized tomography showed large cystic lesion containing fluid with air within it in right mid zone. Initially cystic aspiration followed by pericystectomy was done. Health education, hand washing practices, creating awareness and protection of intermediate host by vaccine will help to control the disease.

Fracture Of Humerus In A Newborn During Cesarean Section: A Case Report

Risk of birth injuries and long bone fractures are common in vaginal breech deliveries but have also occurred in the cesarean section. Here, we report the case of a term neonate who was admitted with swelling and paucity of movement of the right arm with a history of energetic traction during the emergency cesarean section. The diagnosis was confirmed by radiography and managed by plaster of paris slab. Obstetrician and pediatrician should remain vigilant regarding such rare complications so that these cases are not overlooked, as timely intervention and management are necessary to prevent disability and deformities in the future.

Utility of cord blood bilirubin as a predictors of significant neonatal Hyperbilirubinemia in healthy term neonate

Background: Clinical jaundice is evident in more than two-third neonates in their early neonatal life. Early identification of neonates at risk might allow early intervention and prevent complication. Objective of the study was to assess the cord blood bilirubin level as a tool to screen the risk of development of subsequent significant neonatal hyperbilirubinemia in term neonates.Methods: A prospective observational study was conducted over a period of 2 years on 1040 healthy term neonates. Demographic profile, relevant maternal and neonatal information were recorded. Measurement of cord blood bilirubin, blood group/Rh typing and serum bilirubin at the end of 24 & 72 hours was done to predict significant hyperbilirubinemia.Results: Incidence of significant hyperbilirubinemia was 11.53%. Gender, gestational age, mode of delivery and birth weight had no correlation with development of significant jaundice. 800 (76.93%) neonates had cord blood bilirubin level ?3.0mg/dl and 240 (23.07%) neonate had cord blood bilirubin level >3.0mg/dl. Out of 240 (23.07%) neonates with higher cord bilirubin (>3.0 mg/dl), 108 (45%) had significant hyperbilirubinemia at the end of 24 hours with sensitivity 90.00%, specificity 85.65%, positive predictive value 45.00% and negative predictive value 98.50% while 110 (45.83%) neonates were observed with serum bilirubin >17mg/dl at the end of 72 hours with cord blood bilirubin >3mg/dl with sensitivity 91.67%, specificity 84.52% positive predictive value 45.83% and negative predictive value-98.61% and this difference was statistically significant.Conclusions: Neonates with cord blood bilirubin level ?3mg/dl can be safely discharged early whereas neonates with bilirubin >3mg/dl will need close follow up to check for development of subsequent significant jaundice. Hence cord blood bilirubin levels help to determine and predict the possibility of significant jaundice among healthy term neonates.